Pengaruh Kanker Payudara Presentasi Positivitas Estrogen Reseptor (ER) terhadap Relaps Free Survival

Mario Fransisco Catur Widya Karya Tukan, dr. Kunta Setiaji, Sp.B, Subsp. Onk (K).; dr. Sumadi Lukman Anwar, M.Sc., Ph.D., Sp.B., Subsp.Onk(K)

2026 | Tesis-Spesialis | S2 Ilmu Bedah

Latar belakang: Kanker payudara diderita oleh satu dari setiap 8 wanita dan menyumbang 16?ri total keganasan pada wanita dan 25?ri total kanker invasif pada wanita. Kanker payudara dikategorikan menjadi empat subtipe berdasarkan tingkat ekspresi reseptor estrogen (ER), reseptor progesteron (PR), dan human epidermal growth factor receptor 2 (HER2) : luminal A, luminal B, triplenegatif, dan HER2-positif. Sekitar 70% kanker payudara adalah reseptor estrogen (ER) positif dan sebagian besar diobati dengan setidaknya 5 tahun terapi adjuvan endokrin. Pada penyakit ER-positif, 5 tahun pengobatan dengan Tamoxifen mengurangi risiko kekambuhan sekitar 50%.

Tujuan: Mencari hubungan antara kanker payudara presentasi positivitas estrogen reseptor dengan relaps free survival

Metode: Penelitian ini menggunakan rancangan penelitian observasional kohort retrospektif yang bertujuan untuk Mencari hubungan antara kanker payudara presentasi positivitas estrogen reseptor dengan relaps free survival. Penelitian ini dilakukan di Instalasi Catatan Medik RSUP Dr Sardjito Yogyakarta menggunakan data pasien yang di rawat di RSUP Dr. Sardjito dimulai 1 Januari 2017 sampai 31 Desember 2020 secara retrospektif. Presentasi ER di golongkan menjadi kelompok ER 0%, kelompok ER 1-79%, dan kelompok ER ?80%. Kemudian mencari hubungan antara presentasi positifitas estrogen reseptor dengan relaps free survival. Analisis data menggunakan analisis log rank test dan kaplan meier.

Hasil : Didapatkan 149 sampel penelitian. Kelompok pasien kanker payudara dengan tingkat ER 0% memiliki rata-rata waktu bebas relaps 2.140 hari. Kelompok pasien kanker payudara dengan tingkat ER 1–79% memiliki rata-rata waktu bebas relaps 2.455 hari. Kelompok pasien kanker payudara dengan tingkat ER ?80% menunjukkan rata-rata waktu bebas relaps tertinggi, yaitu 2.635 hari. Uji log rank menunjukkan tidak ada hubungan antara presentasi positifitas estrogen reseptor dengan relaps free survival. Berdasarkan kurva Kaplan Meier, kelompok pasien kanker payudara dengan tingkat ekspresi ER 0% memiliki kemungkinan relaps paling cepat dibandingkan kelompok pasien kanker payudara dengan tingkat ekspresi ER 1-79?n ?80%.

Kesimpulan : Pasien kanker payudara dengan tingkat ER 0% memiliki rata-rata bebas relaps 2.140 hari, kelompok pasien kanker payudara dengan tingkat ER 1–79% memiliki rata-rata waktu bebas relaps 2.455 dan kelompok pasien kanker payudara dengan tingkat ER ?80% menunjukkan rata-rata waktu bebas relaps tertinggi yaitu 2.635 hari.

Background: Breast cancer affects one in every 8 women and accounts for 16% of all malignancies in women and 25% of all invasive cancers in women. Breast cancer is categorized into four subtypes based on the expression levels of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2): luminal A, luminal B, triple-negative, and HER2-positive. About 70% of breast cancers are estrogen receptor (ER) positive, and most are treated with adjuvant hormone therapy for at least 5 years. In ER-positive disease, 5 years of treatment with Tamoxifen reduces the risk of recurrence by about 50%.

Objective: To find the corelation between estrogen receptor positivity presentation and relapse-free survival.

Method: This study uses a retrospective cohort observational research design aimed at investigating the corelation between estrogen receptor positivity presentation and relapse-free survival. The study will be conducted at the Medical Records Installation of Dr. Sardjito General Hospital, Yogyakarta, using data from patients treated at Dr. Sardjito General Hospital from January 1, 2017, to December 31, 2020, retrospectively. The percentage of estrogen receptors was classified into the ER 0% group, the ER 1-79% group, and the ER ?80% group. Then, the relationship between estrogen receptor positivity and recurrence-free survival was investigated. Data analysis was performed using the log-rank test and Kaplan-Meier analysis.

Results: A total of 149 research samples were obtained. The group of breast cancer patients with 0% ER levels had an average relapse-free time of 2,140 days. The group of breast cancer patients with ER levels of 1–79% had an average relapse-free time of 2,455 days. The group of breast cancer patients with ER levels ?80% showed the highest average relapse-free time, which was 2,635 days. The log-rank test results showed no association between estrogen receptor positivity and relapse-free survival. Based on the Kaplan-Meier curve, the group of breast cancer patients with 0% ER expression has the fastest likelihood of relapse compared to the groups of breast cancer patients with 1-79% and ?80% ER expression.

Conclusion: Breast cancer patients with an ER level of 0% had an average relapse-free period of 2,140 days, breast cancer patients with an ER level of 1–79% had an average relapse-free period of 2,455 days, and breast cancer patients with an ER level of ?80% showed the highest average relapse-free period of 2,635 days.

Kata Kunci : Kanker payudara, presentasi positivitas estrogen reseptor, Estrogen Receptor, relaps free survival, kematian.